LHSC physicians achieve a Canadian first in using new technology to treat atrial fibrillation

LHSC cardiologists are one of two independent Canadian medical teams to first use a complex arrhythmia tool during a pulmonary vein ablation

(LONDON, Ontario) - London Health Sciences Centre (LHSC) today announced a Canadian first in using new electroanatomical mapping technology to perform a pulmonary vein ablation (PVA) for atrial fibrillation.

On August 24, LHSC cardiologists Dr. Lorne Gula and Dr. Allan Skanes used new local impedance mapping technology to guide the catheter tip and measure cardiac performance during an ablation procedure at the Ivey Heart Centre at LHSC University Hospital. The arrhythmia specialists are one of two independent medical teams who were the first to use this technology in Canada.

“This achievement delivers on the Ivey Heart Centre’s promise to serve as one of Canada’s premier centres for the treatment of heart disease,” says Cliff Nordal, president and chief executive officer. “London Health Sciences Centre physicians have again demonstrated their leadership in using new technology to improve the way in which we care for patients.”

The PVA procedure involves the placement of a catheter into the heart, through a vein in the leg, to areas that can cause atrial fibrillation. These areas are selectively heated until they can no longer conduct the electrical currents that produce atrial fibrillation. Local impedance mapping technology helps guide the positioning of the catheter tip during an ablation procedure by transmitting information onto a three-dimensional electroanatomical screen image.

Gula says the new technique enhances patient safety during the course of the four to six-hour procedure by improving the accuracy of measurements. “The local impedance mapping feature is capable of guiding the catheter tip within a one-millimetre degree of accuracy. This reduces the risk of damaging one of the pulmonary veins that returns blood from the lungs, which can lead to difficulty breathing and the need for additional medical care.”

The system also enhances patient safety by assisting physicians in recognizing locations that could lead to vein damage, and by monitoring the temperature of the catheter tip during the procedure, explains Gula.

Ablations are a highly successful treatment for irregular heart rhythms, and are an important treatment option when heart medication leads to complications or is not successful for a patient,” explains Skanes, who performed the procedure with Gula. “While atrial fibrillation can sometimes take weeks to subside following an ablation procedure, in this case, the patient’s condition was corrected during the course of the procedure and has not returned since.”

Atrial fibrillation is an arrhythmia characterized by an irregular heart rhythm that can lead to weakening of the heart muscle and even stroke in some high-risk patients. Approximately 200,000 to 250,000 Canadians have atrial fibrillation.

Local impedance mapping is a feature of Biosense Webster’s CARTO XP Electroanatomical Mapping System, which is used by physicians to track information on the electrical activity of the heart during a cardiac procedure through three-dimensional electroanatomical maps.

London Health Sciences Centre (LHSC) is one of Canada’s largest acute care teaching hospitals and is dedicated to excellence in patient care, teaching and research. LHSC has pioneered many national and international medical breakthroughs. Located in London, Ontario, LHSC encompasses three sites, South Street Hospital, University Hospital and Victoria Hospital; two family medical centres; and the London Regional Cancer Program. LHSC is the home of the Children’s Hospital of Western Ontario and CSTAR (Canadian Surgical Technologies & Advanced Robotics). The research arm of LHSC is Lawson Health Research Institute, which is partnered with London’s other teaching hospital, St. Joseph’s Health Care, London. LHSC is affiliated with The University of Western Ontario. Physicians and staff at LHSC number close to 9,000 and together they provided care for more than one million patient visits last year.

Photographs

The CARTO XP Electroanatomical Mapping System allows physicians to anatomically view areas in the heart that cause atrial fibrillation, or irregular heart rhythm (image 1), as well as visually place the catheter tip in the left atrium and track ablations as they are performed (image 2).